Conroe psychiatric hospital may face big fines

Updated 10:16 pm, Thursday, July 26, 2012

Texas health officials recommended levying more than $100,000 in fines against the state's first publicly funded, privately run psychiatric hospital in Conroe for violations including the improper restraining and inadequate monitoring of patients and other infractions committed in its first year.

County leaders who oversee the Montgomery County Mental Health Treatment facility and officials with GEO Group, a prison company running the center for mentally incompetent defendants, met with state health officials last week. The company, based in Fort Lauderdale, Fla., contracts with the county, which has a two-year, $15 million-per-year agreement with the state. Since company officials said they have fixed the problems, the state tentatively agreed to halve the fines.

"We take these violations very seriously," said Pablo Paez, a GEO Group spokesman. "We have taken the necessary steps to correct them."

But some mental health advocates said the violations are troubling as state officials conclude a bidding process Friday into privatizing one of the 10 public psychiatric hospitals it oversees.

GEO Care, a subsidiary of GEO Group - which has a checkered recent history in Texas, including allegations of sexual assault by prison guards and deplorable conditions that led the state to shutter one facility it oversaw - is the only company to bid for the contract, said Carrie Williams of the Department of State Health Services.

Williams said the agency is following the decree of lawmakers, who attached a ride to the budget bill last year directed officials to privatize one state mental health hospital and generate at least 10 percent cost savings.

Gyl Switzer, public policy director for Mental Health America of Texas, said she is concerned about GEO Group obtaining the contract because the company "has had significant problems across the country … They have a bad record of treating people who are forced to be in a location, whether that's prisons or psychiatric hospitals."

In Texas, for instance, state officials closed GEO's Coke County Juvenile Justice Center in 2007, citing unsafe conditions. In 2009, a Texas appeals court upheld a $42.5 million verdict against the company for an inmate beaten to death by others using padlocks stuffed into socks. In 2010, GEO Group settled a $3 million class-action lawsuit alleging that inmates were subject to unconstitutional strip searches at a Pennsylvania jail.

Paez, the spokesman, said the company runs 104 - mostly correctional - facilities across the country and "has always strived to provide services of the highest standards … It's not only inaccurate but really unfair to characterize our history as checkered because of isolated incidents."

'Lack of compliance'

According to a July 19 notice of alleged non-compliance and a May 11 notice of licensing violation, state investigators outlined a range of issues it deemed troublesome.

Among them: Half of 50 incidents where officials restrained or secluded patients were not accompanied by an "appropriate" doctor's order. Investigators found a "significant lack of compliance with physician orders for initiating restraint." State law says restraint can only be used when ordered by a doctor and when evidence of imminent harm exists.

Several hospital policies violated patients' rights, state officials found, including a prohibition on possessing items for reasons other than patient safety. Investigators detailed spotty record-keeping, including gaps suggesting patients were not properly monitored, and a lack of documentation related to patient consent for receiving psychoactive medications. The director of psychiatric nursing, meanwhile, had only an associate's degree, not the required master's degree in psychiatric mental health or related experience.

Noting the facility has been accredited by The Joint Commission, a nationally renowned certifier of health care organizations, Paez said: "We don't think the violations by themselves uniquely represent the quality of our services."

Most revolved around "administrative and paperwork lapses," he said, saying that's not unusual for a facility open only for one year.

"We are very satisfied with the job GEO has been doing," said county Commissioner Ed Chance who chairs the board over the hospital. "Like with any new facility, I think you're going to have issues. But they were corrected."

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